Meet
Lauren Makhoul (Cricchi)
Principal
Lauren provides policy, analytic, and due diligence support to clients in the healthcare investment and value-based care delivery space.
With expertise in value-based contracting, particularly alternative payment models (APMs) developed through the CMS Innovation Center and within Medicare Advantage, she monitors developments with CMS quality and value-based programs, identifies best practices across public and private payer markets, and provides analytic support to innovative provider, payer, life sciences, and private equity companies through primary research and financial modeling.
Prior to joining Avalere, Lauren supported CMS through quality measurement development and CMMI value-based payment model implementation at the Lewin Group. Lauren has a BA in public policy and leadership from the University of Virginia.
Authored Content
A white paper explores ways in which VBC payment models can benefit from incorporating allied health domains, such as Orthotics and Prosthetics.
An Avalere analysis assessing differences in Medicare expenditures and utilization across 4 models provides a new perspective on the evolving physician affiliation model landscape.
Avalere analysis reveals an opportunity to support more Medicare beneficiaries with hospice care, as evolving diagnoses and ALOS prompt reevaluation of program metrics
The prevalence and cost of CVD make cardiology a strong candidate for value-based care. Various clinical and market trends present opportunities for continued uptake.
The CMS Innovation Center offers policymakers a nimble, non-legislative pathway to experiment with new methods of care delivery, payment, and reimbursement in Medicare and Medicaid.
In this video, Manoj Pawar, Chief Medical Officer of Mutual of Omaha, joins Avalere experts to discuss their recent partnership on a project that sought to identify innovative ways to use data to inform payer/provider partnerships in the Medicare program.
President Biden’s executive order directs HHS to identify CMMI model options that could lower drug costs and promote access for Medicare and Medicaid enrollees.
Avalere analyzes opportunities for investment in the growing $350-billion market for population-level VBC in Medicare.
It is critical for orthopedic providers to understand key cost drivers to identify opportunities for savings in bundled payment arrangements with private payers.
Avalere estimates that the CMMI will produce net costs of approximately $9.4 billion through 2026, in contrast to the CBO’s projected net savings of $34 billion.
To fully realize the benefits of home-based care, including improved outcomes, inpatient hospital capacity, and patient experience, state and federal regulators may consider formalizing regulatory flexibilities, removing current barriers to participation in models such as Acute Hospital Care at Home, and testing the impacts of these waivers under the Center for Medicare & Medicaid Innovation (CMMI).
In September 2021, Avalere conducted an online survey of 51 US-based health plans and pharmacy benefit managers (PBMs), representing roughly 59 million covered lives. The survey indicates that 56% of payers have executed an outcomes-based contract (OBC) as of September 2021.
A potential recession due to job losses and business closings as a result of COVID-19 will cause shifts in the payer mix and, ultimately, revenue dynamics for physician practices.
The impact of COVID-19 goes beyond the disease and produces additional strain on the healthcare system, including managing patients and meeting cost and quality drivers.
Avalere collaborates with the Endocrine Society and Pottstown Medical Specialists to launch a quality improvement intervention study aimed at addressing care gaps in the identification and management of hypoglycemia in older adults with type 2 diabetes.
This past spring, Avalere and MITRE experts presented “Implementation of the Core Quality Measures Collaborative (CQMC) Core Measure Sets by Public Payers: Successes and Opportunities” at the Pharmacy Quality Alliance (PQA) annual meeting.
In early February, Avalere attended the annual Centers for Medicare & Medicaid Services (CMS) Quality Conference, an annual gathering that brings stakeholders together to address challenges in healthcare quality improvement and discuss ways to spread these solutions locally and nationally.